Modern approach to the diagnosis and therapy of renovascular hypertension
Atanacković, D.
Medicinski Pregled 42(11-12): 424-427
1989
ISSN/ISBN: 0025-8105 PMID: 2642200 Document Number: 341608
Symptoms and sings pointing most often to renovascular hypertension (RH) are the early beginning of the disease, sudden deterioration of the previous hypertension and the presence of a murmur over the flank or in the upper abdomen. The only reliable method for diagnosis is the renal angiography. Determination of the renin plasma activity (RAP) in the blood samples separately withdrawn from the renal veins and calculation of renin gradient or coefficient of its secretion are most often applied for the estimation of the functional significance of stenosis. Peripheral RAP is of no particular importance for the diagnosis of RH. In the cases then technically feasible, the percutaneous transluminal angioplasty has an advantage over the surgical revascularization. Laser thermal angioplasty and intrarenal microvascular surgical procedures are considered methods of choice in the future in some specific cases.